﻿/*
 * Copyright 2008 [rapid-framework], Inc. All rights reserved.
 * Website: http://www.rapid-framework.org.cn
 */

    define("pages/jls_jcjc/JcjcForm.html", [],
        '<div id="dlgJcjc" class="easyui-dialog" title="健康检查"\
                 style="width: 30%; height: 70%; padding: 10px 20px; padding-top: 10px"\
closed="true" buttons="#dlg-buttons" data-options="maximized:true,maximizable:true,minimizable:true,collapsible:true">\                     <div class="easyui-layout" style="height:100%;width:100%">\
                         <div data-options="region:\'center\'" style="">\
         <form id="fmJcjc" method="post" novalidate>\
         <div class="easyui-layout"  style="width: 100%;height:1500px;"  >\
         <div style="width:94%;height: 240px;margin-left: 40px;">\
            <div style="width: 30%;margin-top: 30px;float: left;margin-left: 30px;">\
                <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">案件编号:</label>\
                    <input id="idfm" class="easyui-textbox"  name="id"  style="width: 70%">\
                </div>\
                   <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">心率（次/分）:</label>\
                    <input id="xbfm" class="easyui-textbox"   name="xb"  style="width: 70%">\
                </div>\
                <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">体重（kg）:</label>\
                    <input id="rjyyfm" class="easyui-textbox"    name="rjyy"  style="width: 70%"  required >\
                </div>\
                <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">健康状况:</label>\
                    <select class="easyui-combobox" name="xbtype" id="jkzk" style="width: 70%" required ></select>\
                </div>\
                <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">心电图:</label>\
                    <input id="jlksrqfm" class="easyui-textbox"    name="jlksrq"  style="width: 70%">\
                </div>\
            </div>\
		    <div style="width: 30%;margin-top: 30px; float: left;margin-left: 30px;">\
                <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">姓名:</label>\
                    <input id="idfm" class="easyui-textbox"  name="xm" value="{{data.xm}}" style="width: 70%">\
                </div>\
                   <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">足长（cm）:</label>\
                    <input id="xbfm" class="easyui-textbox"   name="xb"  style="width: 70%"  required >\
                </div>\
                <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:100px;">血压（mmHg）:</label>\
                    <input id="rjyyfm" class="easyui-textbox"    name="rjyy"  style="width: 65%">\
                </div>\
                <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">检查日期:</label>\
                    <input id="rsrqfm" class="easyui-datetimebox"   name="rsrq"  style="width: 70%">\
                </div>\
                <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">脏器:</label>\
                    <input id="jlksrqfm" class="easyui-textbox"    name="jlksrq"  style="width: 70%">\
                </div>\
            </div>\
		    <div style="width: 30%;margin-top: 30px; float: left;margin-left: 30px;">\
                <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">血型:</label>\
                    <select class="easyui-combobox" name="xxtype" id="xxtype" style="width: 70%"></select>\
                </div>\
                   <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">身高（cm）:</label>\
                    <input id="xbfm" class="easyui-textbox"   name="xb"  style="width: 70%"  required >\
                </div>\
                <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">体温（°C）:</label>\
                    <input id="rjyyfm" class="easyui-textbox"    name="rjyy"  style="width: 70%">\
                </div>\
                <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">血常规:</label>\
                    <input id="rsrqfm" class="easyui-textbox"   name="rsrq"  style="width: 70%">\
                </div>\
                <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">胸片:</label>\
                    <input id="jlksrqfm" class="easyui-textbox"    name="jlksrq"  style="width: 70%">\
                </div>\
            </div>\
         </div>\
         <fieldset style="width: 93%;margin-left: 40px; margin-top: 15px;">\
         <legend style="margin: 0 auto;"><input type="checkbox" id="tm1">体貌特征1</legend>\
            <div id="tm1box" style="width: 94%;margin-left: 30px; height: 100px;">\
                <div style="width: 45%;height: 80px;float: left;margin-top: 20px;">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">入所日期:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                    <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">拘留开始时间:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                </div>\
		        <div style="width: 45%;height: 80px;float: right;margin-top:20px; ">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">入所日期:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                    <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">拘留开始时间:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                </div>\
            </div>\
         </fieldset>\
	 <fieldset style="width: 93%;margin-left: 40px; margin-top: 15px;">\
         <legend style="margin: 0 auto;"><input type="checkbox" id="tm2">体貌特征2</legend>\
            <div id="tm2box" style="width: 94%;margin-left: 30px; height: 100px;">\
                <div style="width: 45%;height: 80px;float: left;margin-top: 20px;">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">入所日期:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                    <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">拘留开始时间:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                </div>\
		        <div style="width: 45%;height: 80px;float: right;margin-top:20px; ">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">入所日期:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                    <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">拘留开始时间:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                </div>\
            </div>\
         </fieldset>\
	 <fieldset style="width: 93%;margin-left: 40px; margin-top: 15px;">\
         <legend style="margin: 0 auto;"><input type="checkbox" id="tm3">体貌特征3</legend>\
            <div id="tm3box" style="width: 94%;margin-left: 30px; height: 100px;">\
                <div style="width: 45%;height: 80px;float: left;margin-top: 20px;">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">入所日期:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                    <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">拘留开始时间:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                </div>\
		        <div style="width: 45%;height: 80px;float: right;margin-top:20px; ">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">入所日期:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                    <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">拘留开始时间:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;" ></select>\
                    </div>\
                </div>\
            </div>\
         </fieldset>\
	 <fieldset style="width: 93%;margin-left: 40px; margin-top: 15px;">\
         <legend style="margin: 0 auto;"><input type="checkbox" id="tm4">体貌特征4</legend>\
            <div id="tm4box" style="width: 94%;margin-left: 30px; height: 100px;">\
                <div style="width: 45%;height: 80px;float: left;margin-top: 20px;">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">入所日期:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                    <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">拘留开始时间:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                </div>\
		        <div style="width: 45%;height: 80px;float: right;margin-top:20px; ">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">入所日期:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                    <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">拘留开始时间:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                </div>\
            </div>\
         </fieldset>\
	 <fieldset style="width: 93%;margin-left: 40px; margin-top: 15px;">\
         <legend style="margin: 0 auto;"><input type="checkbox" id="tm5">体貌特征5</legend>\
            <div id="tm5box" style="width: 94%;margin-left: 30px; height: 100px;">\
                <div style="width: 45%;height: 80px;float: left;margin-top: 20px;">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">入所日期:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                    <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">拘留开始时间:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                </div>\
		        <div style="width: 45%;height: 80px;float: right;margin-top:20px; ">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">入所日期:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                    <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">拘留开始时间:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;" ></select>\
                    </div>\
                </div>\
            </div>\
         </fieldset>\
				<div class="fitem" style=" margin-bottom: 10px ;width:30%;float:left;margin-left:60px;margin-top:20px;">\
                        <label  style="display: inline-block;width:90px;">行走状况:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width:70%" ></select>\
                </div>\
				<div class="fitem" style=" margin-bottom: 10px; width:30%;float:left;margin-left:20px;margin-top:20px;">\
                        <label  style="display: inline-block;width:90px;">表达能力:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 70%" ></select>\
                </div>\
				<div class="fitem" style=" margin-bottom: 10px; width:30%;float:left;margin-left:20px;margin-top:20px;">\
                        <label  style="display: inline-block;width:90px;">过敏史:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 70%" ></select>\
                </div>\
				<div class="fitem" style=" margin-bottom: 10px; width:30%;float:left;margin-left:60px;margin-top:20px;">\
                        <label  style="display: inline-block;width:90px;">设置病号:</label>\
						<input type="radio" name="szbh" />不设置\
						<input type="radio" name="szbh" />重点病号\
						<input type="radio" name="szbh" />普通病号\
                </div>\
		<fieldset style="width: 93%;margin-left: 40px; margin-top: 15px;">\
            <legend style="margin: 0 auto;"><input type="checkbox" id="tbsqbox">体表伤情</legend>\
            <div id="tbsq" style="width: 94%;margin-left: 30px; height: 180px;">\
                <div style="width: 45%;height: 80px;float: left;margin-top: 20px;">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">致伤部位:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                    <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">致伤日期及原因:</label>\
                        <input id="zrs_jyaq" class="easyui-textbox" data-options="multiline:true" style="height:60px;width:370px">\
                    </div>\
                </div>\
		        <div style="width: 45%;height: 80px;float: right;margin-top:20px; ">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">采取措施:</label>\
                        <select class="easyui-combobox" name="xbtype" id="xbtype" style="width: 352px;"></select>\
                    </div>\
                    <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:90px;">伤势:</label>\
                        <input id="zrs_jyaq" class="easyui-textbox" data-options="multiline:true" style="height:60px;width:370px">\
                    </div>\
                </div>\
				<div class="fitem" style=" margin-bottom: 10px; width:70%;float:left;margin-left:20px;margin-top:20px;">\
                        <label  style="display: inline-block;width:310px;">此伤情是否为暴力拒捕行凶、脱逃、自残、自杀行为: </label>\
						<input type="radio" name="bljbxx" />是\
						<input type="radio" name="bljbxx" />不是\
                </div>\
            </div>\
         </fieldset>\
		 <fieldset style="width: 93%;margin-left: 40px; margin-top: 15px;">\
            <legend style="margin: 0 auto;"><input type="checkbox" id="tsjcxmbox">特殊检查项目</legend>\
            <div id="tsjcxm" style="width: 94%;margin-left: 30px; height: 100px;">\
                <div style="width: 31%;height: 80px;float: left;margin-top: 20px;">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                       <label  style="display: inline-block;width:130px;">育龄女性妊娠检查: </label>\
						<input type="radio" name="ylnx" />未检查\
						<input type="radio" name="ylnx" />已检查\
                    </div>\
                    <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:130px;">糖尿病人员检查: </label>\
						<input type="radio" name="tnbryjc" />未检查\
						<input type="radio" name="tnbryjc" />已检查\
                    </div>\
                </div>\
		        <div style="width: 31%;height: 80px;float: left;margin-top:20px; ">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:130px;">涉赌人员毒检: </label>\
						<input type="radio" name="sdrydj" />未检查\
						<input type="radio" name="sdrydj" />已检查\
                    </div>\
                </div>\
				<div style="width: 31%;height: 80px;float: right;margin-top:20px; ">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:130px;">艾滋病人员检查: </label>\
						<input type="radio" name="azbjc" />未检查\
						<input type="radio" name="azbjc" />已检查\
                    </div>\
					<div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:130px;">流行病检查: </label>\
						<input type="radio" name="lxbjc" />未检查\
						<input type="radio" name="lxbjc" />已检查\
                    </div>\
                </div>\
            </div>\
         </fieldset>\
         <div style="width: 45%;height: 30px;float: left;margin-top:20px;margin-left: 60px; ">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:130px;">聋哑人: </label>\
						<input type="radio" name="lyr" />未检查\
						<input type="radio" name="lyr" />已检查\
                    </div>\
                </div>\
		<div style="width: 45%;height: 30px;float: right;margin-top:20px; ">\
			        <div class="fitem" style=" margin-bottom: 10px">\
                        <label  style="display: inline-block;width:280px;">智力严重低下、侏儒、两性人、生活不能自理的: </label>\
						<input type="radio" name="zldx" />未检查\
						<input type="radio" name="zldx" />已检查\
                    </div>\
        </div>\
		 <div style="width: 28%;margin-top: 30px; float: left;margin-left: 60px;">\
                <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">自述疾病:</label>\
                    <input id="zrs_jyaq" class="easyui-textbox" data-options="multiline:true" style="height:60px;width:270px">\
                </div>\
                   <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">医生意见:</label>\
                    <input id="zrs_jyaq" class="easyui-textbox" data-options="multiline:true" style="height:60px;width:270px">\
                </div>\
         </div>\
	     <div style="width: 28%;margin-top: 30px; float: left;margin-left: 30px;">\
                <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">家庭病史:</label>\
                    <input id="zrs_jyaq" class="easyui-textbox" data-options="multiline:true" style="height:60px;width:270px">\
                </div>\
                   <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">备注:</label>\
                    <input id="zrs_jyaq" class="easyui-textbox" data-options="multiline:true" style="height:60px;width:270px">\
                </div>\
                </div>\
			    <div style="width: 28%;margin-top: 30px; float: left;margin-left: 30px;">\
                <div class="fitem" style=" margin-bottom: 10px">\
                    <label  style="display: inline-block;width:90px;">传染病:</label>\
                    <input id="zrs_jyaq" class="easyui-textbox" data-options="multiline:true" style="height:60px;width:270px">\
                </div>\
                <div class="fitem" style=" margin-bottom: 10px;margin-top: 20px;">\
                    <label  style="display: inline-block;width:90px;">检查人:</label>\
                    <input id="zrs_jyaq" class="easyui-textbox" style="width:270px">\
                </div>\
         </div>\
         </div>\
         </form>\
            </div>\
         </div>\
        </div>\
    <div id="dlg-buttons">\
        <a href="#" class="easyui-linkbutton" iconCls="icon-ok" id="jcjc_save">保存</a>\
        <a href="#" class="easyui-linkbutton" iconCls="icon-cancel" id="jcjc_cancel">关闭</a>\
    </div>');